Tyler Larsen Profile picture
May 29, 2021 16 tweets 6 min read Read on X
1/ Email inbox got you down?

This thread is designed for new chiefs residents (and faculty!) on a topic I got very little coaching on before my chief resident year: Email Management.

Keep reading for Tyler’s Top 10 email tips!

#TipsForNewChiefs Image
2/
My transition to chief year was abrupt. I went from being a decent doctor to a crappy administrator overnight. In this new role I went from receiving a few junk emails/day to hundreds of emails at all hours. The following tips are strategies that helped me survive my inbox.
3/
1️⃣ Set boundaries.

It's easy to be on your email 24 h/day- but it's okay not to be.

Unless I was chief on call I tried not reply to email past 6pm as that is family time. I also limited checking on weekends and vacation. Setting Do-Not-Disturb and downtime can be helpful. Image
4/
I still try (and continually fail) to abide by these boundaries now. Obviously buy-in from your colleagues is essential. I told my co-chiefs about my desire for boundaries beforehand and was grateful for their support and accountability in keeping them.
5/

2️⃣ Turn off notifications.

The constant interruption of beeps and pop-ups can really be distracting and disruptive when you’re focusing on more important work. I highly recommend turning them off and just checking your inbox at pre-defined times. Image
6/
3️⃣ Avoid the temptation to immediately reply to everything.

It’s important to be timely, but don’t feel you have to reply instantaneously all the time. You’ll be surprised at how many situations resolve themselves if you embargo your reply until the next morning.
7/
4️⃣ Long emails are a cry for help - try not to respond in kind.

Sometimes the best way to respond to a long email is to pick up the phone and talk to someone. It will save everyone so much time. Image
8/
5️⃣ Stay organized - use folders.

I use my inbox only for emails that I am actively working on. Everything else gets moved to a few organizational folders to avoid clutter and to help in referencing prior emails since the search function in Outlook is abysmal. Image
9/
6️⃣ Wish someone would sort the email for you? - Use inbox rules!

Inbox rules allow you to automatically route emails that do not apply to you to the appropriate place, such as the trash. They can be a great time-saver and help keep your inbox clean. Image
10/

7️⃣ Going to be sending the same email on a recurring basis? - Use templates!

The desktop version of Outlook allows you to use custom template files to easily load an email with correct formatting without having to search, copy/paste, and edit the last email you sent. Image
11/
8️⃣ Going to be emailing groups regularly? - Set up contact lists!

If you find that you regularly email groups that do not have established listservs you can create your own. This saves you from having to manually add everyone and accidentally forgetting someone. Image
12/
9️⃣ Need to remember to follow up on an item? - Use tasks and flags!

If you take an email and drag it to the tasks (clipboard) icon on the bottom left of Outlook, it will automatically create a to-do list item for you to follow up on and allow you to set yourself reminders. Image
13/
🔟 Need to remind someone else about an item? - Schedule an email reminder!

You can now schedule/delay send emails on both the Outlook web and desktop apps. This is really helpful for reminding busy faculty about the lecture you booked them for months prior. Image
14/
If I had to summarize I would say effective email management comes down to 3 things:
💌 Boundaries
💌 Organization
💌 Working smarter, not harder.
15/
A huge thanks goes to my former @uclaimchiefs colleagues @LizzieAbyMD and @jmjones204 who helped inspire some of these tips/tricks, as well as email super-user and all-around bad-ass @kelleychuang who taught me the way of email folder organization!
16/
Lastly, these tips are based on my personal experience and may not work for everyone. I am sure there are many others who would have different advice. What pointers would other #MedTwitter folks share for rising chiefs and faculty with regard to email?

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More from @TylerLarsenMD

Aug 16, 2022
1/ Do you prescribe Incentive Spirometry (IS) for postoperative patients?

Is the routine use of IS to prevent postoperative pulmonary complications (PPCs) a "Thing We Do For No Reason?"

Let's explore IS in the following #tweetorial!

#MedTwitter
2/ PPCs are extremely common and associated with a high rate of morbidity and mortality following surgery.

While no one agrees on which conditions we should include in PPCs, most agree that atelectasis (collapsed lung tissue) is the most common PPC.
3/ Though it's common, the significance of postoperative atelectasis isn't always clear.

While there is no evidence to support the dogma that atelectasis causes early postoperative fever, atelectasis frequently accompanies more serious complications including pneumonia & death.
Read 17 tweets
Oct 13, 2021
1/
Why is metformin associated with lactic acidosis? Do we need to routinely stop metformin when admitting patients with Type 2 Diabetes Mellitus (T2DM) to the hospital?

Let's explore these questions by looking at the history of metformin in the following #histmed #tweetorial.
2/
Metformin, a biguanide, works by decreasing hepatic glucose production and increasing insulin sensitivity.

It is a first-line therapy in T2DM because it's inexpensive, well-tolerated, helps with weight loss, and has very low risk of hypoglycemia.

ncbi.nlm.nih.gov/pmc/articles/P…
3/
Metformin derives from galega officinalis, a plant long used in European folk medicine.

First synthesized in the 1920s, metformin was shown to lower blood glucose in rabbits but it was soon forgotten and eclipsed by the discovery insulin.
Read 19 tweets
May 31, 2021
1/ Did you know that you can import an Excel spreadsheet schedule into Google Calendar?

This thread is designed for new chief residents or any folks who schedule conferences/events and want to convert a spreadsheet into individual calendar events.

#TipsForNewChiefs
2/
During my time as a @uclaimchiefs we shared a google calendar to track tasks during the week. We also scheduled conferences via shared spreadsheets.

Importing the spreadsheet allowed me to view what conference was scheduled without constantly referencing the spreadsheet.
3/
To start we’ll need a basic spreadsheet to schedule events.

For this tweetorial we’ll use an example of a Noon Conference spreadsheet and include “Day", “Date", “Title", “Speaker", and “Notes" as headers though for this spreadsheet the headers are not critical.
Read 12 tweets
Jan 17, 2021
1/ Why are hypodermic needles and IV catheters referenced by gauge numbers?

And why does the needle diameter get smaller as the gauge number increases?

Let's explore the obscure history of IV sizing in the following #histmed #tweetorial.
2/ The gauge numbers on modern hypodermic needles are adapted from the Birmingham Wire Gauge (BWG), a system developed during the Industrial Revolution in the early 1800s to standardize the British cottage industry of iron and steel wire manufacturing.
3/ As early as the 1200s wire was made through the process of wire-drawing, which involved pulling iron rods through a conical hole in a draw-plate or gauge.

The resultant wires could then be drawn through successively smaller diameter gauges to produce thinner wire.
Read 11 tweets
Nov 18, 2020
1/
Why does obesity cause a "falsely low" B-type natriuretic peptide (BNP) in patients with heart failure?

I often hear this used to explain unexpectedly low BNP results, but I've never really understood why.

Let's explore in a #tweetorial.

#medtwitter #cardiotwitter
2/
Before we answer this question, a quick poll.

What is the main physiologic mechanism of BNP?
3/
BNP is a hormone secreted in response to ventricular wall stretch. It binds to natriuretic peptide receptor A (NPR-A) which ⬆️ cGMP in various tissues to exert MANY effects including:
⬆️ Natriuresis
⬇️ RAAS
⬇️ sympathetic tone
& so much more!

cardiovascmed.ch/article/doi/cv…
Read 19 tweets
Apr 17, 2020
1/ "Who feels comfortable evaluating a tracheostomy?"

Today on the wards we talked trachs. Though we see patients with trachs regularly I find it is a topic that few learners are comfortable with.

The following 🧵 is my "Hospitalists' Guide to Tracheostomies"
2/

Where are trachs placed anatomically?

Trachs are placed between the cricoid cartilage and the sternal notch around the 2nd to 4th tracheal ring. These can be placed surgically or percutaneously at the bedside.
3/
Anatomy of a Trach

When evaluating a trach, I find it helpful to consider the following:
🔹 Diameter - Is there an inner cannula or single lumen?
🔹 Length - Is it regular size or an Extended Length Trach (XLT)?
🔹 Cuffed or cuffless?
🔹 Fenestrations present?
Read 15 tweets

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